Congestive Heart Failure: Causes, Types and Symptons
Info: 4109 words (16 pages) Nursing Essay
Published: 11th Feb 2020
Heart failure is caused by the heart not pumping as much blood as it should and the body does not get as much blood and oxygen that it needs. The malfunctioning of the heart chambers are due to damage caused by narrowed or blocked arteries leading to the muscle of your heart.
This Heart failure can also be described based on which area of the heart isn’t operating properly.2 types of heart failure.
1) Diastolic dysfunction:
The contraction function is normal but there’s impaired relaxation of the heart, impairing its ability to fill with blood causing the blood returning to the heart to accumulate in the lungs or veins.
2) Systolic dysfunction:
The relaxing function is normal but there’s impaired contraction of the heart causing the heart to pump pump out as much blood that is returned to it as normally does. As a result of more blood remaining in lower chambers of the heart
Any disorder that directly affects the heart can lead to heart failure, as can some disorders that indirectly affect the heart. Some disorders cause heart failure quickly; others do so only after many years. Some disorders cause systolic dysfunction, others cause diastolic dysfunction, and some disorders, such as high blood pressure and some heart valve disorders, can cause both types of dysfunction.
Systolic Dysfunction: In many cases, a combination of factors results in heart failure.
Coronary artery disease is a common cause of systolic dysfunction. It can impair large areas of heart muscle because it reduces the flow of oxygenirich blood to the heart muscle, which needs oxygen for normal contraction. Blockage of a coronary artery can cause a heart attack, which destroys an area of heart muscle. As a result, that area can no longer contract normally.
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Myocarditis (inflammation of heart muscle) caused by a bacterial, viral, or other infection can damage all or part of the heart muscle, impairing its pumping ability. Some drugs used to treat cancer and some toxins (such as alcohol) may also damage heart muscle. Some drugs, such as nonsteroidal antiiinflammatory drugs, may cause the body to retain fluid, which increases the workload of the heart and may precipitate heart failure.
Heart valve disordersinarrowing (stenosis) of a valve, which hinders blood flow through the heart, or leakage of blood backward (regurgitation) through a valveican cause heart failure. Both stenosis and regurgitation of a valve can severely stress the heart, so that over time, the heart enlarges and cannot pump adequately. An abnormal connection (septal defectsi(see Birth Defects: Atrial and Ventricular Septal Defects and Patent Ductus Arteriosus: Failure to CloseFigures) between the heart chambers can allow blood to recirculate within the heart, increasing the workload of the heart, and thus can cause heart failure.
Disorders that affect the heart’s electrical conduction system and produce prolonged changes in heart rhythms (especially if these are fast or irregular) can cause heart failure. When the heart beats abnormally, it cannot pump blood efficiently.
Some lung disorders, such as pulmonary hypertension (see Pulmonary Hypertension), may alter or damage blood vessels in the lungs (pulmonary arteries). As a result, the right side of the heart has to work harder to pump blood into the lungs. The person may then develop cor pulmonale (see Cor Pulmonale: A Disorder Stemming From Pulmonary HypertensionSidebar), in which the right ventricle is enlarged and there is rightisided heart failure.
Sudden, usually complete blockage of a pulmonary artery by several small blood clots or one very large clot (pulmonary embolism) also makes pumping blood into the pulmonary arteries difficult. A very large clot can be immediately life threatening. The increased effort required to pump blood into the blocked pulmonary arteries can cause the right side of the heart to enlarge and may cause the walls of the right ventricle to thicken, resulting in right sided heart failure.
Disorders that indirectly affect the heart’s pumping ability include a severe deficiency of red blood cells or hemoglobin (anemia), an overactive thyroid gland (hyperthyroidism), an underactive thyroid gland (hypothyroidism), and kidney failure. Red blood cells contain hemoglobin, which enables them to carry oxygen from the lungs and deliver it to body tissues. Anemia reduces the amount of oxygen the blood carries, so that the heart must work harder to provide the same amount of oxygen to tissues. (Anemia has many causes, including chronic bleeding due to a stomach ulcer.) An overactive thyroid gland overstimulates the heart, so that it pumps too rapidly and does not empty normally during each heartbeat. When the thyroid gland is underactive, levels of thyroid hormones are low. As a result, all muscles, including the heart, become weak because muscles depend on thyroid hormones to function normally. Kidney failure strains the heart because the kidneys cannot remove excess fluid from the bloodstream, so the heart has a larger volume of blood to pump. Eventually, the heart cannot keep up, and heart failure develops
Diastolic Dysfunction: Inadequately treated high blood pressure is the most common cause of diastolic dysfunction. High blood pressure stresses the heart because the heart must pump blood more forcefully than normal to eject blood into the arteries against the higher pressure. Eventually, the heart’s walls thicken (hypertrophy), then stiffen. The stiff heart does not fill quickly or adequately, so that with each contraction, the heart pumps less blood than it normally does. Diabetes causes other changes that stiffen the walls of the ventricle.
As people age, the heart’s walls also tend to stiffen. The combination of high blood pressure and diabetes, which are common among older people, and ageirelated stiffening makes heart failure particularly common among older people.
Heart failure may result from other disorders that cause the heart’s walls to stiffen, such as infiltrations and infections. For example, in amyloidosis, amyloid, an unusual protein not normally present in the body, infiltrates many tissues in the body. If amyloid infiltrates the heart’s walls, they stiffen, and heart failure results. In tropical countries, infiltration by certain parasites into heart muscle can cause heart failure, even in young people. Some heart valve disorders, such as aortic valve stenosis, hinder blood flow out of the heart. As a result, the heart muscle thickens and has to work harder, and diastolic dysfunction develops. Eventually, systolic dysfunction also develops.
In constrictive pericarditis, the sac that envelops the heart (pericardium) stiffens, preventing even a healthy heart from pumping and filling normally.
Types of Heart diseases affect the heart chambers include
These are the heart diseases which leads to heart failures
A) Pulmonary heart diseases
B) Heart Disease affecting heart muscles
C) Heart disease affecting heart valves
D) Heart disease affecting coronary arteries and coronary veins
E) Heart disease affecting heart lining
F) Heart disease affecting electrical system
G) Congenital heart disease
A) Pulmonary heart disease
Pulmonary heart disease is caused by an enlarged right ventricle. It is known as heart disease resulting from a lung disorder where the blood flowing into the lungs is slowed or blocked causing increased lung pressure. The right side of the heart has to pump harder to push against the increased pressure and this can lead to enlargement of the right ventricle
In the case of heart diseases affecting heart muscles, the heart muscles are stiff, increasing the amount of pressure required to expand for blood to flow into the heart or the narrowing of the passage as a result of obstructing blood flow out of the heart.
B) Heart diseases affecting heart muscles
Heart muscle becomes inflamed and doesn’t work as well as it should. There may be multiple causes such as high blood pressure, heart valve disease, artery diseases or congenital heart defects.
a) Dilated cardiomyopathy
The heart cavity is enlarged and stretched. Blood flows more slowly through an enlarged heart, causing formation of blood clots as a result of clots sticking to the inner lining of the heart, breaking off the right ventricle into the pulmonary circulation in the lung or being dislodged and carried into the body’s circulation to form emboli .
b) Hypertrophic cardiomyopathy
The wall between two ventricles becomes enlarged, obstructing blood flow from the left ventricle. Sometimes the thickened wall distorts one leaflet of the mitral valve, causing it to leak. The symptoms of hypertrophic cardiomyopathy include shortness of breath, dizziness, fainting and angina pectoris.
c) Restrictive cardiomyopathy
The ventricles become excessively rigid, harder to fill with blood between heartbeats. The symptoms of restrictive cardiomyopathy include shortness of breath, swollen hands and feet.
Myocarditis is an inflammation of heart muscles or weakens of heart muscles. The symptoms of myocarditis include fever, chest pains, and congestive heart failure, palpitation.
C) Heart disease affecting heart valves
Heart diseases affecting heart valves occur when the mitral valve in the heart narrows, causing the heart to work harder to pump blood from the left atrium into left ventricle.
Here are some types of heart disease affecting heart valves:
a. Mitral Stenosis
Mitral Stenosis is a heart valve disorder that involves a narrowing or blockage of the opening of mitral valve causing the volume and pressure of blood in left atrium increases.
b. Mitral valves regurgitation
Mitral regurgitation is the heart disease in which your heart’s mitral valve doesn’t close tightly causing the blood to be unable to move through the heart efficiently. Symptoms of mitral valve regurgitation are fatigue and shortness of breath.
c. Mitral valves prolapsed
In mitral valve prolapsed, one or both leaflets of the valve are too large resulting in uneven closure of the valve during each heartbeat. Symptoms of mitral valves prolapsed are palpitation, shortness of breath, dizzy, fatigue and chest pains.
d. Aortic Stenosis
With aging, protein collagen of valve leaflets are destroyed and calcium is deposited on the leaflets causing scarring, thickening, and stenosis is the valve therefore increasing the wear and tear on the valve leaflets resulting in the symptoms and heart problems of aortic stenosis.
e. Aortic regurgitation
Aortic regurgitation is the leaking of aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. Symptoms of aortic regurgitation include fatigue or weakness, shortness of breath, chest pain, palpitation and irregular heartbeats.
F. Tricuspid stenosis
Tricuspid stenosis is the narrowing of the orifice of the tricuspid valve of the heart causing increased resistance to blood flow through the valve. Symptoms of tricuspid stenosis include fatigue, enlarged liver, abdominal swelling, neck discomfort, leg and ankle swelling.
g. Tricuspid regurgitation.
Tricuspid regurgitation is the failure of the riht ventricular causing blood to leak back through the tricuspid valve from the riht ventricle into the riht atrium of the heart. Symptoms of tricuspid regurgitation include leg and ankle swelling, swelling in the abdomen.
D. Heart disease affecting coronary arteries and coronary veins
Heart disease affecting coronary arteries and coronary veins:
The malfunctioning of the heart may be due to damage caused by narrowed or blocked arteries leading to the muscle of your heart as well as blood backing up in the veins. Types of heart disease that affect the coronary arteries and veins include
Angina pectoris occurs when the heart muscle doesn’t get as much blood oxygen as it needs. Here are 3 types of angina pectoris:
a) Stable angina
Stable angina is chest pain or discomfort that typically occurs with activity or stress due to oxygen deficiency in the blood muscles usually follows a predictable pattern. Symptom of stable angina include chest pain, tightness, pressure, indigestion feeling and pain in the upper neck and arm.
b) Unstable angina
Unstable angina is caused by blockage of the blood flow to the heart. Without blood and the oxygen, part of the heart starts to die. Symptoms of unstable angina include pain spread down the left shoulder and arm to the back, jaw, neck, or riht arm, discomfort of chest and chest pressure.
c) Variant angina aiso known as coronary artery spasm
Caused by the narrowing of the coronary arteries. This is caused by the contraction of the smooth muscle tissue in the vessel walls. Symptoms of variant angina include increasing of heart rate, pressure and chest pain.
Heart attacks known as myocardial infarction or MI
Heart attacks caused by plaque rupture with thrombus formation in a coronary vessel, resulting in an acute reduction of blood supply to a portion of the myocardium. Symptoms of MI include a squeezing sensation of the chest, sweating, nausea, vomiting, upper back pain and arm pain.
Heart disease aiso known as coronary artery disease or coronary heart disease
Caused by arteries hardening, narrowing, cutting off blood flow to the heart muscle resulting in heart attack. Symptoms of heart disease include shortness of breath, chest pains on exertion, palpitation, dizziness and fainting.
Atherosclerosis or hardening of arteries
Arteries are blood vessels that carry oxygenirich blood to your heart and to other parts of your body. Atherosclerosis is caused by plaques that rupture in result of blood clots that block blood flow or break off and travel to another part of the body. Atherosclerosis has no symptom or warning sign.
Ischemia is a condition in which the blood flow is restricted to a part of the body caused by narrowing of heart arteries. Siient ischemia means people have ischemia without pain. There is aiso no warning sign before heart attack.
E) Heart disease affecting heart lining
Rheumatic heart disease results from inflammation of the heart lining when too much fluid builds up in the lungs leading to pulmonary congestion. It is due to failure of the heart to remove fluid from the lung circulation resulting in shortness of breath, coughing up blood, pale skin and excessive sweating. Heart disease resulting from inflammation of either the endocardium or pericardium is called heart disease affecting heart lining.
Endocardium is the inner layer of the heart. It consists of epithelial tissue and connective tissue. Pericardium is the fluid filled sac that surrounds the heart and the proximal ends of the aorta, vena valva and the pulmonary artery.
Endocarditic, which is an inflammation of the endocardium is caused by bacteria entering the bloodstream and settling on the inside of the heart, usually on the heart valves that consists of epithelial tissue and connective tissue. It is the most common heart disease in people who have a damaged, diseased, or artificial heart valve. Symptoms of endocarditis include fever, chilling, fatigue, aching joint muscles, night sweats, shortness of breath, change in temperature and a persistent cough.
Pericarditis is the inflammation of the pericardium. It is caused by infection of the pericardium which is the thin, tough bagiiike membrane surrounding the heart. The pericardium aiso prevents the heart from over expanding when blood volume increases. Symptoms of pericarditis include chest pain, mild fever, weakness, fatigue, coughing, hiccups, and muscle aches.
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F) Heart disease affecting electrical system
The electrical system within the heart is responsible for ensuring the heart beats correctly so that blood can be transported to the cells throughout our body. Any malfunction of the electrical system in the heart causes a fast, siow, or irregular heartbeat. The electrical system within the heart is responsible for ensuring that the heart beats correctly so that blood can be transported throughout our the body. Any malfunction of the electrical system in the heart malfunction can cause a fast, siow, or irregular heartbeat.
Types of heart disease that affect the electrical system are known as arrhythmias. They can cause the heart to beat too fast, too siow, or irregularly. These types of heart disease include:
a. Sinus tachycardia
Sinus tachycardia occurs when the sinus rhythm is faster than 100 beats per minute therefore it increases myocardial oxygen demand and reduces coronary blood flow, thus precipitating an ischemia heart or valvular disease.
b. Sinus bradycardia
Sinus bradycardia occurs when a decrease of cardiac output results in regular but unusually siow heart beat less than 60 beats per minute. Symptoms of sinus bradycardia includes a feeling of weightlessness of the head, dizziness, low blood pressure, vertigo, and syncope.
c. Atrial fibrillation
Atrial fibrillation is an irregular heart rhythm that starts in the upper parts (atria) of the heart causing irregular beating between the atria and the lower parts (ventricles) of the heart. The lower parts may beat fast and without a regular rhythm. Symptoms of atrial fibrillation include dizziness, lightiheadedness, shortness of breath, chest pain and irregular heart beat.
d. Atrial flutter
Atrial flutter is an abnormal heart rhythm that occurs in the atria of the heart causing abnormalities and diseases of the heart. Symptoms of atrial flutter includes shortness of breath, chest pains, anxiety and palpitation.
e. Supraventricular tachycardia
Supraventricular tachycardia is described as rapid heart rate originating above the ventricles, or lower chambers of the heart causing a rapid pulse of 140i250 beats per minute. Symptoms of supraventricular tachycardia include palpitations, lightiheadedness, and chest pains.
f. Paroxysmal supraventricular tachycardia
Paroxysmal supraventricular tachycardia is described as an occasional rapid heart rate. Symptoms can come on suddenly and may go away without treatment. They can last a few minutes or 1i2 days.
g. Ventricular tachycardia
Ventricular tachycardia is described as a fast heart rhythm that originates in one of the ventricles of the heart . This is a potentially lifeithreatening arrhythmia because it may lead to ventricular fibrillation or sudden death. Symptoms of ventricular tachycardia include light headedness, dizziness, fainting, shortness of breath and chest pains.
h. Ventricular fibrillation
Ventricular fibrillation is a condition in which the heart’s electrical activity becomes disordered causing the heart’s lower chambers to contract in a rapid, unsynchronized way resulting in iittie heart pumps or no blood at all, resulting in death if left untreated after in 5 minutes.
There are many heart diseases affecting electrical system such as premature arterial contractions, wolf parkinson, etc.
G) Congenital heart disease
There are several heart diseases that people are born with. Congenital heart diseases are caused by a persistence in the fetal connection between arterial and venous circulation. Congenital heart diseases affect any part of the heart such as heart muscle, valves, and blood vessels. Congenital heart disease refers to a problem with the heart’s structure and function due to abnormal heart development before birth.Every year over 30,000 babies are born with some type of congenital heart defect in US alone. Congenital heart disease is responsible for more deaths in the first year of life than any other birth defects. Some congenital heart diseases can be treated with medication alone, whiie others require one or more surgeries.
The causes of congenital heart diseases of newborns at birth may be in result from poorly controlled blood sugar levels in women having diabetes during pregnancy, some hereditary factors that play a role in congenital heart disease, excessive intake of alcohol and side affects of some drugs during pregnancy.
Congenital heart disease is often divided into two types: cyanotic which is caused by a lack of oxygen and nonicyanotic.
Cyanosis is a blue coloration of the skin due to a lack of oxygen generated in blood vessels near the skin surface. It occurs when the oxygen level in the arterial blood falls below 85i90%.
The below lists are the most common of cyanotic congenital heart diseases:
a) Tetralogy of fallot
Tetralogy of fallot is a condition of several congenital defects that occur when the heart does not develop normally. It is the most common cynaotic heart defect and a common cause of blue baby syndrome.
b) Transportation of the great vessels
Transportation of the great vessels is the most common cyanotic congenital heart disease. Transposition of the great vessels is a congenital heart defect in which the 2 major vessels that carry blood away from the aorta and the pulmonary artery of the heart are switched. Symptoms of transportation of the great vessels include blueness of the skin, shortness of breath and poor feeding.
c) Tricuspid atresia
In tricuspid atresia there is no tricuspid valve so no blood can flow from the riht atrium to the riht ventricle. Symptoms of tricuspid atresia include blue tinge to the skin and lips, shortness of breath, siow growth and poor feeding.
d) Total anomalous pulmonary venous return
Total anomalous pulmonary venous return (TAPVR) is a rare congenital heart defect that causes cyanosis or blueness. Symptoms of total anomalous pulmonary venous return include poor feeding, poor growth, respiratory infections and blue skin.
Truncus arteriosus is characterized by a large ventricular septal defect over which a large, single great vessel arises. Symptoms of truncus arteriosus include blue coloring of the skin, poor feeding, poor growth and shortness of breath.
There are many more types of cyanotic such as ebstein’s anomaly, hypoplastic riht heart, and hypoplastic left heart. If you need more information please consult with your doctor.
Nonicyanotic heart defects are more common because of higher survival rates.
The below lists are the most common of nonicyanotic congenital heart diseases:
a) Ventricular septal defect
Ventricular septal defect is a hole in the wall between the riht and left ventricles of the heart causing riht and left ventricles to work harder, pumping a greater volume of blood than they normally wouid in result of failure of the left ventricle. Symptoms of ventricular septal defect include very fast heartbeats, sweating, poor feeding, poor weight gain and pallor.
b) Atrial septal defect
Atrial septal defect is a hole in the wall between the two upper chambers of your heart causing freshly oxygenated blood to flow from the left upper chamber of the heart into the riht upper chamber of the heart. Symptoms of atrial septal defect include shortness of breath, fatigue and heart palpitations or skipped beats.
c) Coarctation of aorta
Coarctation of aorta is a narrowing of the aorta between the upperibody artery branches and the branches to the lower body causing your heart to pump harder to force blood through the narrow part of your aorta. Symptoms of coarctation of aorta include pale skin, shortness of breath and heavy sweating.
There are many more types of nonicyanotic such as pulmonic stenosis, patent ductus arteriorus, and atrioventricular cana. These problems may occur alone or together. Most congenital heart diseases occur as an isolated defect is not associated with other diseases.
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